Individual provider Active NPI

Desiree Mazzarelli, LPC, LCADC

  • Mental Health Counselor
  • Clayton, NJ
National Provider Identifier
1922593391
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37PC00756900 Issued in NJ
Practice address
1 Lacy CT
Clayton, NJ 08312-1540
Phone
(856) 229-2512
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00249100 NJ
Mental Health Counselor 101YM0800X 37PC00756900 NJ Primary

Addresses

Primary practice location

1 Lacy CT
Clayton, NJ 08312-1540

Mailing address

1 Lacy CT
Clayton, NJ 08312-1540
Phone (856) 229-2512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404001902 NJ Practitioner - Mental Health Counselor 6406294826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Acenda, Inc.Group PAC ID 0042290678, 27 clinicians

Practice addresses (Care Compare)

42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone (844) 422-3632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00249100NJMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Better Living Counseling Services Addiction (Substance Use Disorder) Current Accepting new patients
Acenda, Inc. Mental Health CurrentSince Mar 3, 2024 Accepting new patients

Locations

42 Delsea Dr S
Glassboro, NJ 08028
Phone (856) 863-0006

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1922593391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LACY CT",
            "city": "CLAYTON",
            "state": "NJ",
            "postal_code": "083121540",
            "telephone_number": "856-229-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LACY CT",
            "city": "CLAYTON",
            "state": "NJ",
            "postal_code": "083121540",
            "telephone_number": "856-229-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZARELLI",
        "first_name": "DESIREE",
        "name_prefix": "Mrs.",
        "credential": "LPC, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00249100",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00756900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NJ

Sources for this page

Verify at the official NPI Registry.